The Use of Adipose-Derived Progenitor Cells and Platelet-Rich Plasma Combination for the Treatment of Supraspinatus Tendinopathy in 55 Dogs: A Retrospective Study

Abstract

ObjectiveTo report clinical findings and outcomes for 55 dogs with supraspinatus tendinopathy (ST) treated with adipose-derived progenitor cells and platelet-rich plasma (ADPC-PRP) therapy.MethodsMedical records of client-owned dogs diagnosed with ST that were treated with ADPC-PRP combination therapy were reviewed from 2006 to 2013. Data collected included signalment, medical history, limb involvement, prior treatments, physical and orthopedic examination, objective temporospatial gait analysis findings, diagnostic imaging results (radiography, magnetic resonance imaging, musculoskeletal ultrasonography), arthroscopy findings, and outcome.ResultsFollowing ultrasound-guided injection of ADPC-PRP, objective gait analysis was available on 25 of the 55 dogs at 90 days post ADPC-PRP therapy. Following treatment, a significant increase in total pressure index percentage (TPI%) was noted in the injured (treated) forelimb at 90 days post treatment (p = 0.036). At 90 days following treatment, 88% of cases had no significant difference in TPI% of the injured limb to the contralateral limb. The remaining 12% of cases had significantly improved (p = 0.036). Bilateral shoulder diagnostic musculoskeletal ultrasound revealed a significant reduction in tendon size (CSA) in the treated tendon at 90 days following treatment when compared to the initial CSA (p = 0.005). All cases showed significant improvement in fiber pattern of the affected supraspinatus tendon by the ultrasound shoulder pathology rating scale.Clinical RelevanceThese findings suggest that ADPC-PRP therapy should be considered for dogs with ST.

Isolation of canine adipose‐derived mesenchymal stem cells from falciform tissue obtained via laparoscopic morcellation: A pilot study

“…Approximately 1 × 10 6 to 1 × 10 7 AD‐MSC have been successfully used for the treatment of osteoarthritis, tendonopathy, spinal cord injury, pancreatitis, IBD, and gingivostomatitis . The minimum number of passage 0 (or original) stem cells required to achieve this number of cells after expansion in culture has not been identified, to the best of the authors’ knowledge.…”

“…Mesenchymal stem cell (MSC) therapies are emerging as potential adjunct or single‐agent treatments for a variety of inflammatory and immune‐mediated conditions in veterinary medicine, including osteoarthritis, tendonopathy, spinal cord trauma, keratoconjunctivitis sicca, pancreatitis, inflammatory bowel disease (IBD), and feline gingivostomatitis . In these applications, stem cells are used for their autocrine and paracrine immunomodulatory effects . Adipose‐derived MSC (AD‐MSC) have gained in popularity because of the abundance and ease of harvesting adipose tissue, documented multipotency of the cells, greater self‐renewal capacity, and superior MSC:volume ratio compared to bone marrow‐derived MSC …”

The Contribution of Adipose Tissue-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma to the Treatment of Chronic Equine Laminitis: A Proof of Concept

“…With regard to this point, it must be considered that since aMSCs and PRP have been administered in combination, their single contribution to the clinical amelioration of the laminitic foot could not be determined in the present investigations. From this point of view, the combination therapy could be considered a limitation of the study, as already pointed out in the literature [ 36 , 37 , 38 ]. Nonetheless, it must be underlined that the combination of the two biological therapeutics has been frequently adopted in recent years to develop regenerative medicine therapeutic protocols [ 35 ], and we opted for their contemporary intravenous administration with the aim of enhancing tissue healing and clinical outcome in severely affected animals which failed to respond to conventional treatments.…”

Ultrasonographic Findings in 41 Dogs Treated with Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for a Supraspinatus Tendinopathy: A Retrospective Study

“…Fiber pattern and echogenicity of the supraspinatus tendon have been previously evaluated in both humans and dogs, along with well-established markers of tendinopathy including a heterogenous fiber pattern, indicative of intratendinous hemorrhage or an acute partial tear, regions of hypoechogenicity, consistent with intratendinous edema, and regions of hyperechogenicity or acoustic shadowing, evidence of scar tissue formation or intratendinous calcification ( 4, 11–15 ). These markers are often used for diagnostic purposes, ( 2, 15–17 ) however, changes in fiber pattern and echogenicity have also been used to evaluate patient responses to treatment ( 16, 17 ).…”

“…Intratendinous injection of mesenchymal stem cells (MSC), represents an alternative treatment that has demonstrated promising clinical benefits ( 16, 24–27 ). The potential advantages of using such cells include their regenerative capacity, or their ability to differentiate into tenocytes, as well as their ability to modulate the local inflammatory response, regulate cellular apoptosis, and induce neovascularization ( 24, 28–32 ).…”